Your Health: How Is Bacterial Meningitis Spread?

I've previously referred to John Aravosis' post on AmericaBlog from last Saturday where, referring to the meningitis outbreak in New York City, he asks: "Should you get vaccinated against a deadly meningitis outbreak?" Looking more closely at his piece, he clears up some questions I have about how this deadly meningitis disease is spread.

What we know is that bacterial meningitis (meningococcal meningitis) is contagious and can be spread through close contact, coughing, sneezing, wet kissing and sharing utensils, cups, cigarettes where there's an exchange of saliva. Here's how Aravosis put it after talking with Dr. Thomas Clark, an epidemiologist and meningitis expert at the US Centers for Disease Control and Prevention (CDC):

I was quite surprised about how the bacteria is transmitted. As the NY warnings are targeted at gay men, and specifically at men who seek sex partners online, at a party, or at a bar, I just assumed that this was sexually transmitted. It's not.

More after the break.

The bacteria is transmitted through secretions of the mouth, nose and throat - large-sized droplets. What that means is the droplets are far too large to float in the air. So it's the kind of thing you're more likely to get from French kissing, or having someone cough in your face or accidentally spit in your face while talking, or even sneezing - but regular aerosolized drops in sneezes won't get you sick, it's the larger droplets that do it. That's why the warnings talked about "close contact." What they found was that people living together, even if they're not in a romantic relationship, we're at a "very high risk" of contracting the disease from each other.

Can meningitis be transmitted by sex? No, but...

Not only are the mouth, nose and throat instrumental for transmitting the bacteria, they're also instrumental for receiving the bacteria. So oral sex isn't going to transmit it, so long as your mouth doesn't come into contact with anyone else's saliva - same goes for any other sex act, the key issue is your mouth (or nose) coming into contact with someone else's saliva. (emphasis mine) I was surprised about that, since I figured this would be transmitted similarly to an STD. Not so, said Dr. Clark. Even though the bacteria is a cousin of the bacteria that causes gonorrhea, while gonorrhea adapted to the genital tract as a venue of transmission, this bacteria adopted to the nose and throat. It is also not, however, as easily spread as an STD.

You're not at risk if you work with someone who gets sick.

Because the bacteria requires prolonged face-to-face contact, simply working in an office alongside someone who came down with meningitis would not put you at risk, Dr. Clark told me.

So the bottom line appears to be: you are at risk if you have a prolonged contact with someone who's been exposed to meningitis or if you've gotten the spittle - saliva or mucus - of an exposed person in your mouth or nose. Some people can be exposed and not get sick but most likely a person who's been exposed to this bacterial infection will develop symptoms within three to seven days - sudden fever, headaches, nausea, vomiting, in rash in some cases. In Brett Shaad's case, he apparently started feeling sick on Monday, April 8, one week later; he went into Cedars Sinai and was diagnosed with meningococcal meningitis on Wednesday, went into a coma on Thursday and was brain dead by Friday. Aravosis notes:

The bad news is that you can become quite ill quickly, and if you don't get medical help you can die. The good news is that the quick onset of the disease makes it harder to spread. Why? Because once you're in bed sick as a dog, you really don't feel like going online and hooking up, or going to a bar and drinking with your buddies. So the disease generally only gets a chance to spread in that 24 to 48 hour window after you're first exposed and still feeling fine, which thus limits the spread of the disease.

Part of the problem, of course, is we don't know yet how Brett Shaad came down with meningitis, how many people might have been exposed through him (through kissing, for instance) during the window in which he was contagious, and whether those people actually caught the disease or fended it off and are fine.

In any case, please practice good and polite hygiene by regularly washing your hands, covering your mouth when you sneeze or cough and if you find yourself shouting over music or some other noise in a restaurant or bar, make sure you do not inadvertently spit while talking or get any spittle from the other person in your mouth or nose. We must all try to stop the spread of this deadly disease as soon as possible.

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